Lyme Disease Psychiatric Symptoms: Anxiety, Depression, and Brain Effects
Psychiatric symptoms may have a medical cause
Lyme disease can affect the brain
Symptoms may persist despite treatment
Lyme disease psychiatric symptoms can complicate diagnosis when anxiety, depression, or cognitive changes appear alongside physical complaints.
In the article “New-onset Panic, Depression with Suicidal Thoughts and Somatic Symptoms in a Patient with a History of Lyme Disease”, the authors highlight how overlapping psychiatric and medical symptoms can make diagnosis challenging.
These symptoms often overlap with those described in the Lyme disease symptoms guide, particularly fatigue, neurologic complaints, and cognitive dysfunction.
Case Presentation
A 37-year-old man presented with panic attacks, depression with suicidal thoughts, and multiple physical symptoms.
His symptoms included:
- Palpitations and chest pressure
- Tremulousness and choking sensation
- Fear of dying
- Fatigue and poor sleep
- Back pain, muscle spasms, and weakness
- Numbness and tingling in extremities
- Loss of appetite and weight loss
Despite treatment with psychiatric medications, his symptoms persisted.
History of Lyme Disease
The patient had been diagnosed with Lyme disease two years earlier following a tick bite and flu-like illness.
Although he completed antibiotic therapy, he continued to experience anxiety and neurologic symptoms.
Repeated testing, including Western blot, was negative—highlighting issues discussed in Lyme disease testing limitations.
Persistent Symptoms and Psychiatric Admission
The patient required inpatient psychiatric care due to worsening depression and suicidal thoughts.
Ongoing symptoms included:
- Fatigue and weakness
- Pain and muscle spasms
- Cognitive impairment and forgetfulness
- Poor concentration
These symptoms contributed to significant distress and impaired daily functioning.
Role of Coinfections
Further evaluation revealed evidence of Babesia coinfection.
Coinfections can increase symptom severity and prolong recovery, often contributing to fatigue, sweats, headaches, and emotional symptoms.
These overlapping patterns are explored further in Lyme disease co-infections, where multiple pathogens complicate treatment.
Response to Treatment
After six months of combination antibiotic therapy, the patient’s cognitive symptoms improved.
Notably, his panic attacks and suicidal thoughts resolved, and psychiatric medications were discontinued.
This outcome raises important questions about the relationship between infection, inflammation, and psychiatric symptoms.
Neuropsychiatric Lyme Disease
Borrelia burgdorferi may affect the central nervous system, leading to cognitive dysfunction and psychiatric symptoms.
When neurologic involvement is present, treatment may differ from early Lyme disease and sometimes includes therapies targeting central nervous system infection.
These patterns are part of broader neurologic involvement described in neurologic Lyme disease.
Why This Case Matters
Psychiatric symptoms may not always originate from a primary psychiatric disorder.
When psychiatric symptoms occur alongside unexplained physical complaints, an underlying medical condition should be considered.
Failure to recognize this overlap may delay appropriate treatment.
Clinical Perspective
This case highlights the importance of a multidisciplinary approach.
Patients with psychiatric symptoms and a history of Lyme disease may benefit from evaluation for persistent infection and co-infections, alongside appropriate psychiatric care.
Integrating medical and behavioral health treatment may improve outcomes in complex cases.
References
- Garakani A, Mitton AG. Case Rep Psychiatry. 2015.
Dr. Daniel Cameron, MD, MPH
Lyme disease clinician with over 30 years of experience and past president of ILADS.
Symptoms • Testing • Coinfections • Recovery • Pediatric • Prevention
My husband was diagnosed with Lyme and Babesia about 9 years ago. He has been undergoing treatment ever since. He changed providers last year and his new provider wants him to be re-tested by Igenex. I’m concerned that if the tests are only IGG positive she will not continue to treat him. Are you aware of any methods to “provoke” activity to get a positive (IGM) result? Thank you!
I don’t have a way to provoke an IgM. Some doctors dismiss the IgM if someone has been ill for more than a month. Your doctor will have to use clinical judgment at the Igg stays positive even if the infection has resolved. Call my office at 914 666 4665 if you have any questions.
My 28 year old daughter is having panic attacks almost daily. She experienced childhood trauma and was also diagnosed with Lyme disease in 2015 but is not able to complete treatment due to the onset of anxiety and panic around treatments and her physical symptoms. Can you recommend an inpatient treatment center that can address both the mental/emotional and physical issues?
I work with complex presentations in my practice. I understand how hard it is to find the right in-patient program. I don’t know of any programs. I have patients that have had an in patients experience but they have found it difficult to find a doctor with experience treating Lyme disease with psychiatric issues.
Dr Cameron,
Thank you for what you do for the Lyme community! I was diagnosed with Babesia Duncani and Lyme by IGENEX labs in Feb 2020. I started treatement the first week of March with DOXY Azithromycin Ceftin and Mepron. My symptoms felt more neurological in June and my LLMD tested me for BART through Galaxy and I was PCR positive. We then stopped my babesia treatment and focused my regiment on Bart and I tested clear of BART in August and September through IGENEX W-Blot, Galxay tripple draw, and T-lab. However My babisia titer was higher than in Feb (340). I was feeling good through September- October so I was taken off antibiotics. In late October I started to develop that odd neurological anxiety. My symptoms now are anxiety, shortness of breath, slight heart palpitations, depression, neurological slight cognitive impairment. My LLMD thinks that I have lyme or BART persisters and is putting me on Horowitz’s Double Dapsone protocol. (Dapsone build to 200MG a day, Minocycline, Bacrtrim DS, Oregano oil, AlliMax, and I will take 50mg of Methylene blue a day for the last 4 weeks of treatment). My question, Will this treatment also address my Babesia Duncani? Should I address Babesia prior to heavy Bart and Lyme protocol?
I do not believe your proposed combination works for Babesia. I typically return to Babesia before the new protocol. Other doctor disagree.
Caught Lyme on east coast 2009. Was prescribed 10 days of doxycycline right when I found the bullseye. (4 days after tick removal). Physical symptoms went away within 2 weeks. A year later, came down with OCD symptoms (first time ever- I was 43 years old). Had a death in the family during that year as well and attributed OCD to that. But wonder if it could be Lyme. Last Lyme test I had was in 2015 I believe and it was still showing positive for IgM but not IgG. (So looks like recent infection in my blood work). Could Lyme be causing my mental health issues or just coincidence? Therapy has helped some, SSRIs made me worse, but a decade later, I’m miserable emotionally. Doctors just chalk it up to emotional trauma but I can’t understand why I can’t seem to get better., and why such a late onset in life. I don’t have any physical symptoms.
I don’t know where to turn. I live in the Midwest so very few deal with Lyme much. I tried someone in Maryland and they just said “well sometimes you don’t seroconvert, keep an eye on your heart just in case”. Another doctor asked if maybe I had syphilis. (That one cracked me up. I know you can get a false positive for Lyme with syphilis, but I found it funny).
Any advice would be so appreciated.
I find it difficult to determine if a tick-borne illness is part of the problem. The tests are not as reliable as I would like. An IgM western blot test can come and go in some patients without ever developing an IgG western blot test. I advise my patients to continue their psychiatric care while looking a second time at a tick borne illness.
Tet books from Dr. Jay Davidson, Dr. Horowitz. Lookup Dr Buhner, join fb group “Microbe Formulas Detox Heroes”. Join Mivrobe Forumulas website for a wealth of videos. For my daughter the physical healing began with functional medicine. Find a lyme literate medical doctor (LLMD) is another option
Hello
I received the 2nd moderna vaccine. The next morning I had a stiff neck and back and headaches. Also, a lot of anxiety. I was treated for lyme 5 years for over 2 years. My symptoms approved. Could the vaccine make my lyme symptoms reappear? Thank you
The symptoms following a COVID-19 can resemble symptoms of Lyme disease even in patients without a history of Lyme disease. I have patients and readers of my blog who are sharing their experience. It is hard to know what symptoms are from the COVID-19 vaccine or a flare-up of Lyme disease. Some Lyme disease patients face flare-ups with or without a vaccine. Many of my patients and readers have suffered from immune issues related to Lyme disease. My patients and readers are only making these tough decisions given the severity of COVID-19 in some individuals.
Hi Dr. Cameron,
My daughter suffered from Lyme’s disease and mononucleosis concurrently when she was in middle school. Approximately 2 years later, she developed sudden onset of severe anxiety and depression. Assay shows that she still has a few positive bands, which are not enough to warrant treatment according to her PCP. My daughter has now graduated high school and her psych symptoms are so severe that she cannot function at all. A friend of mine has a teenage daughter who experienced similar severe psychiatric symptoms after Lyme’s disease and mono on a similar timeline. Do you think there could be a relationship between Lymes/mono and psychiatric illness?
I have seen patients in my practice with the same presentations. Others have too. Here is a blog https://danielcameronmd.com/dont-be-mislead-patients-can-have-both-mono-and-lyme-disease/
The tests are not so reliable.
Hi Dr. Cameron,
My daughter suffered from Lyme’s disease and mononucleosis concurrently when she was in middle school. Approximately 2 years later, she developed sudden onset of severe anxiety and depression. Assay shows that she still has a few positive bands, which are not enough to warrant treatment according to her PCP. My daughter has now graduated high school and her psych symptoms are so severe that she cannot function at all. A friend of mine has a teenage daughter who experienced similar severe psychiatric symptoms after Lyme’s disease and mono on a similar timeline. Do you think there could be a relationship between Lymes/mono and psychiatric illness?